Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA.
Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA.
Cancer. 2022 Nov 1;128(21):3831-3842. doi: 10.1002/cncr.34446. Epub 2022 Sep 6.
Understanding biological differences between different racial groups of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) patients, who have differences in terms of incidence, survival, and tumor morphology, can facilitate accurate prognostic biomarkers, which can help develop personalized treatment strategies.
This study evaluated whether there were morphologic differences between HPV-associated tumors from Black and White patients in terms of multinucleation index (MuNI), an image analysis-derived metric that measures density of multinucleated tumor cells within epithelial regions on hematoxylin-eosin images and previously has been prognostic in HPV-associated OPSCC patients. In this study, the authors specifically evaluated whether the same MuNI cutoff that was prognostic of overall survival (OS) and disease-free survival in their previous study, T , is valid for Black and White patients, separately. We also evaluated population-specific cutoffs, T for Blacks and T for Whites, for risk stratification.
MuNI was statistically significantly different between Black (mean, 3.88e-4; median, 3.67e-04) and White patients (mean, 3.36e-04; median, 2.99e-04), with p = .0078. Using T , MuNI was prognostic of OS in the entire population with hazard ratio (HR) of 1.71 (p = .002; 95% confidence interval [CI], 1.21-2.43) and in White patients with HR of 1.72 (p = .005; 95% CI, 1.18-2.51). Population-specific cutoff, T , yielded improved HR of 1.77 (p = .003; 95% CI, 1.21-2.58) for White patients, whereas T did not improve risk-stratification in Black patients with HR of 0.6 (p = .3; HR, 0.6; 95% CI, 0.2-1.80).
Histological difference between White and Black patient tumors in terms of multinucleated tumor cells suggests the need for considering population-specific prognostic biomarkers for personalized risk stratification strategies for HPV-associated OPSCC patients.
了解不同种族 HPV 相关口咽鳞状细胞癌 (OPSCC) 患者之间的生物学差异，这些患者在发病率、生存率和肿瘤形态方面存在差异，可以促进准确的预后生物标志物的发展，从而帮助制定个性化的治疗策略。
本研究评估了 HPV 相关肿瘤在多核指数 (MuNI) 方面是否存在黑人和白人患者之间的形态学差异，MuNI 是一种基于图像分析的指标，用于测量上皮区域内多核肿瘤细胞的密度，以前在 HPV 相关 OPSCC 患者中具有预后意义。在这项研究中，作者专门评估了之前研究中用于预测总生存期 (OS) 和无病生存期 (DFS) 的 MuNI 截止值 T 是否适用于黑人和白人患者，分别。我们还评估了用于风险分层的人群特异性截止值 T ，用于黑人，T ，用于白人。
黑人和白人患者的 MuNI 差异具有统计学意义（平均值分别为 3.88e-4 和 3.36e-04；中位数分别为 3.67e-04 和 2.99e-04），p =.0078。使用 T ，MuNI 在整个人群中是 OS 的预后指标，风险比 (HR) 为 1.71（p =.002；95%置信区间 [CI]，1.21-2.43），白人患者的 HR 为 1.72（p =.005；95% CI，1.18-2.51）。人群特异性截止值 T ，白人患者的 HR 提高到 1.77（p =.003；95% CI，1.21-2.58），而 T 并没有提高黑人患者的风险分层，HR 为 0.6（p =.3；HR，0.6；95% CI，0.2-1.80）。
白人和黑人患者肿瘤在多核肿瘤细胞方面的组织学差异表明，需要考虑针对 HPV 相关 OPSCC 患者的个性化风险分层策略的人群特异性预后生物标志物。
